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Öğe Acute traumatic diaphragmatic ruptures: A retrospective study of 48 cases(Springer, 2011) Dirican, Abuzer; Yilmaz, Mehmet; Unal, Bulent; Piskin, Turgut; Ersan, Veysel; Yilmaz, SezaiPurpose. Traumatic diaphragmatic rupture (TDR) is associated with high rates of morbidity and mortality, and the preoperative diagnosis is difficult. Methods. Forty-eight patients with TDR were treated in our department between January 2000 and May 2009. The cause, location, size of rupture, associated morbidity and mortality, surgical material for repair, and predictive factors for overall outcome were evaluated. Results. There were 41 male patients (85%) and 7 female patients (15%) with a mean age of 33.8 years (range 17-69 years). Blunt trauma accounted for the injuries of 15 patients (31%) and 33 patients (68%) had penetrating injuries. The diagnosis was preoperatively established in 12 patients (25%) with a plain chest X-ray or/and computed tomography. The location of rupture was on the left side of the diaphragm in 35 patients (73%), on the right side in 10 (21%), and was bilateral in 3 patients (6%). Traumatic diaphragmatic rupture was repaired with interrupted nonabsorbable sutures or polypropylene mesh (8 patients). Postoperative complications were observed in 18 patients (38%). Overall mortality was observed in 7 patients (15%). The mortality was associated with hemorrhagic shock (P = 0.002), a high injury severity score (P = 0.002), and having additional injuries (P = 0.015). Conclusion. The outcome of the patients is associated with presence of hemorrhagic shock, a high injury severity score, and additional organ injury.Öğe Appendiceal Carcinoid Tumor within Amyand's Hernia: A Case Report and Review of the Literature(Wolters Kluwer Medknow Publications, 2019) Sarici, Baris; Akbulut, Sami; Piskin, TurgutIntroduction: Amyand's hernia is defined as the herniation of the whole or a part of appendix vermiformis into an inguinal hernia sac. Amyand's hernia is very rare, constituting about 1% of all inguinal hernia patients and 0.1% of all acute appendicitis patients. In one-quarter of Amyand's hernia patients, inflammatory changes are detected in appendix vermiformis. Detecting an appendiceal tumor in an Amyand's hernia sac is extremely rare, with only eight cases having been reported so far in the English literature. Case presentation: A 64-year-old man with an appendiceal carcinoid tumor inside an incarcerated Amyand's hernia sac. As the tumor was localized to the radix of the appendix, resection was carried out with the help of a linear-cutter stapler in a way to contain a part of the cecal wall. As the pathology examination revealed a carcinoid tumor infiltrating the periappendicular fatty tissue, right hemicolectomy was performed in a second session, in compliance with the oncological principles. No metastasis was present at the 24th month. Case reports published in the English literature regarding the Amyand's hernia with an appendiceal tumor were also analyzed in this study. Conclusion: Amyand's hernia containing an appendiceal tumor is an extremely rare clinical entity. Clinical manifestations mostly mimic the incarcerated hernia and thus accurate diagnosis is made incidentally during hernia surgery. The basic oncological principles apply for the approach to tumors inside a hernia sac.Öğe A case of acute small bowel obstruction due to metastasis of undiagnosed primary carcinoma of the lung(Aves, 2009) Ara, Cengiz; Dirican, Abuzer; Ozgor, Dincer; Piskin, Turgut[Abstract Not Available]Öğe The causes of death-censored graft loss among kidney transplant recipients(2024) Ciftci, Felat; Simsek, Arife; Piskin, Turgut; Unal, Bulent; Dogan, Sait Murat; Ulutas, Ozkan; Tabel, YilmazAim: This study presents the causes of death-censored graft loss among kidney transplant recipients. Materials and Methods: Medical records of the patients, who had undergone kidney transplantation at a tertiary center between November 2010 and December 2018, were retrospectively reviewed. Death-censored graft loss was described as an irreversible graft failure signified by return to long-term dialysis (or re-transplantation). Inclusion criteria were: patients who had undergone kidney transplantation, and subsequently lost their first graft, and a follow-up of more than one year after kidney transplantation. Results: Of 269 kidney transplant recipients, 33 recipients with a mean age of 33.54 ± 15.37 years (17 male and 16 female) were included in the study. The rate of death-censored graft loss was 12.26%. Of graft failures, 3.03% occurred in the hyperacute phase, 18.18% in the acute phase, and 78.78% in the chronic phase. Chronic allograft nephropathy was the leading cause of graft failure (48.48%). Other causes were medical problems (18.18), immunological problems (18.18%) and surgical complications (15.15%). Conclusion: Identification of the true causes of graft failure described under the heading chronic allograft nephropathy is noteworthy. Comprehensive biochemical, physiological, pathological, immunological, and genetÖğe Complications of Bursectomy after Radical Gastrectomy for Gastric Cancer(Springer, 2012) Kayaalp, Cuneyt; Piskin, Turgut; Olmez, Aydemir[Abstract Not Available]Öğe The Effect of Melatonin Against FK506-Induced Renal Oxidative Stress in Rats(Sage Publications Inc, 2011) Ara, Cengiz; Dirican, Abuzer; Unal, Bulent; Karabulut, Aysun Bay; Piskin, TurgutBackground: Nephrotoxicity is an important side effect of FK506 and oxidative stress has been considered as one of the possible mechanisms. The present investigation examines the ability of melatonin to protect against FK506-induced renal oxidative stress. Methods: Thirty rats were divided into 3 groups (n = 10 each group). Group A was the sham group. Group B received 14 days FK506 (5 mg/kg/d, intraperitoneally [i.p.]) and group C received FK506 (5 mg/kg/d, i.p.) together with melatonin (4 mg/kg, i.p.) for 14 days. Kidney tissues were harvested to determine the tissue levels of malondialdehyde (MDA), total nitrite and nitric oxide (NO), tumor necrosis factor-alpha (TNF-alpha), and interleukin-6 (IL-6). Results: In group C, the levels of TNF-alpha, IL-6, and NO were lower than in the group B (P < .01, P < .03, and P < .04, respectively) and although MDA levels were lower than in group B, the differences were not statistically significant (P > .05). Conclusion: These results suggest that melatonin has protective effect against FK506-induced renal oxidative stress.Öğe Factors Affecting eGFR Slope of Renal Transplant Patients During the First 2 Years(Elsevier Science Inc, 2019) Atay, Feyza Firat; Taskapan, Hulya; Berktas, Bayram; Yildirim, Okan; Dogan, Murat; Piskin, TurgutPurpose. In healthy individuals, glomerular filtration rate decreases by 1 mL/min/y after a peak level of 125.0 mL/min has been reached in adulthood. Any reduction greater than this is a progressive slope (slope more negative than 1 mL/min/y, stable [-1 to +1]), or an improvable slope if it shows more of an increase, that is, greater than +1.0 mL/min/y). The aim of the study was to determine the factors affecting estimated glomerular filtration rate (eGFR) slope during the first 2 years of renal transplant in patients with negative pretransplant panel-reactive antibody. Materials and Methods. The characteristics of 59 renal transplant patients, such as age, sex, etiology, and 2 years of laboratory data, were collected retrospectively. For each patient, the eGFR decline rate (slope) (mL/min-1/1.73 m(2)-1/y-1) was determined by linear regression analysis using all calculated eGFR values over the study period. Findings. Of 59 patients, 7 (11.8%) had a progressive slope, 22 (37.2%) had a stable slope, and 30 (50.8%) had an improvable slope. The first-year mean tacrolimus level was lower in patients with progressive slope than in the patients with stable slope and improvable slope (P < .022). The determinants of eGFR slope in multiple regression analysis were post-transplant hypertension (beta = 0.393; P = .002) and the first-year mean tacrolimus level (beta = 0.320; P =.01), whereas age, serum albumin, and 2-year mean tacrolimus level did not reach the level of significance. Conclusion. Keeping tacrolimus levels high in the first year to prevent eGFR declining is important.Öğe INITIAL EXPERIENCES OF POST TRANSPLANTATION URETERAL STENOSIS OF SINGLE TRANSPLANATION CENTER(Wiley, 2013) Unal, Bulent; Piskin, Turgut; Mamedov, Ruslan; Sahin, Idris; Yilmaz, Sezai[Abstract Not Available]Öğe Investigation of a One-Time Phenol Application for Pilonidal Disease(Karger, 2010) Kayaalp, Cuneyt; Olmez, Aydemir; Aydin, Cemalettin; Piskin, Turgut; Kahraman, LatifObjective: To investigate wound healing rates and postoperative recovery of patients after a one-time phenol application for pilonidal disease. Subjects and Methods: A total 30 consecutive patients with chronic pilonidal disease ranging from midline to complex sinuses were enrolled in the study. No preoperative laboratory examinations or bowel preparation were required. No antibiotic prophylaxis or sedation was used. A small incision was made on the midline and hair/debris in the sinuses was removed. A cotton swab with saturated phenol was moved into the cavity and the phenol was left for 2 min. No special dressing was necessary and patients left the hospital immediately afterwards. Patients filled out a daily questionnaire for 7 days. We did not intervene in the wounds with a second phenol application or curettage during the observation period. Wounds were inspected at weekly intervals for 2 months. Results: At the end of the third day, 97% of the patients were pain-free and 100% of the patients were free from analgesics. Time off work was 2 days for most patients (93.3%). Twenty-eight ( 93.3%) patients were satisfied with the procedure, they found it easy and painless and suggested the procedure to other patients. Twenty-five (83%) patients were asymptomatic at the end of 2 months' observation and the remaining 5 patients had un-healed sinuses. Mean time for wound healing was 25 days ( range 10-63 days). There were 4 recurrences after a mean of 14 months' follow-up and the overall success rate was 70%. Conclusions: A one-time phenol application was an effective treatment for pilonidal disease with acceptable wound healing rates, less postoperative pain and less time off work. Hence it can be an alternative treatment modality. Copyright (C) 2010 S. Karger AG, BaselÖğe Jejunal diverticulum perforation resulting from distal mechanic obstruction: A case report(Aves, 2011) Olmez, Aydemir; Sumer, Aziz; Piskin, Turgut; Aydin, CemalettinExcluding Meckel's diverticulum, jejunum and ileum diverticula are acquired diverticula which are rarely observed and have an asymptomatic course. They are mostly observed in elderly patients. Men are twice as likely as women to have diverticula. The complications like inflammation, bleeding, obstruction and perforation may develop in less than 10% of patients with jejunal diverticula. Perforation, as an uncommon complication, may occur following diverticulitis in 82%, blunt trauma in 12%, and impact of foreign body in 6% of cases. Herein we present a 62 year old man operated emergently due to development of acute abdomen that resulted from perforation caused by an increased jejunal and diverticular pressure secondary to rectal obstruction without any common factors mentioned for diverticular perforation. We performed resection and anastomosis at operation.Öğe Laparoscopic Drainage of Pyogenic Liver Abscess(Soc Laparoendoscopic Surgeons, 2010) Aydin, Cemalettin; Piskin, Turgut; Sumer, Fatih; Barut, Bora; Kayaalp, CuneytBackground and Objectives: Pyogenic liver abscesses are mainly treated by percutaneous aspiration or drainage under antibiotic cover. If interventional radiology fails, surgical drainage becomes necessary. Recently, we performed laparoscopic liver abscess drainage successfully, and we aimed to focus on the topic in light of a systematic review of the literature. Methods: A 22-year-old man was admitted with a 4.5-cm multiloculated abscess in the left lobe of the liver. The abscess did not resolve with antibiotic-alone therapy. Percutaneous aspiration was unsuccessful due to viscous and multiloculated contents. Percutaneous catheter placement was not amenable. Laparoscopic abscess drainage was preferred over open abscess drainage. We used 3 trocars, operation time was 40 minutes, and blood loss was minimal. In the mean time, we searched PubMed using the key words [(liver OR hepatic) abscess*] AND [laparoscop* OR (minimal* AND invasiv*)]. Results: Postoperative recovery of the patient was uneventful, and the patient was asymptomatic after 3 months of follow-up. In the literature search, we found 53 liver abscesses (51 pyogenic and 2 amebic) that were treated by laparoscopy. Mean success rate was 90.5% (range, 85% to 100%) and conversion rate was zero. Conclusion: Treatment of liver abscess is mainly percutaneous drainage. Laparoscopic drainage should be selected as an alternative before open drainage when other modalities have failed.Öğe Management of non-vascular complications following renal transplantation using percutaneous approach(Edizioni Luigi Pozzi, 2018) Yildirim, Ismail Okan; Berktas, Bayram; Saglik, Semih; Piskin, Turgut; Dogan, Murat; Sahin, Idris; Taskapan, HulyaOBJECTIVE: Non-vascular complications following renal transplantation can cause graft failure. In this study, we present our two-year experience with percutaneous treatment for non-vascular complications following renal transplantation. PATIENTS AND METHODS: A total of 30 patients who underwent percutaneous radiological treatment between March 2014 and July 2016 were included in the study. RESULTS: Following renal transplantation, a total of 36 percutaneous radiological procedures which includes hydronephrosis secondary to ureteral stricture (n. 15), clinical symptom producing lymphocele due to pressure (14) and creatinine elevated nondilated grafts (n. 7) after excluding other reasons of creatinine elevation, were performed. Six patients received percutaneous treatment for both ureteral stricture and lymphocele. The patients underwent balloon dilatation and double-J ureteral stent due to ureteral stricture. The mean pre- and post-procedural creatinine levels were 4.36 +/- 2.84mg/dL and 2.17 +/- 1.24 mg/dL respectively (p=0.004), indicating a significant difference. For lymphocele treatment, sclerosing agents were injected and lymphatic leakage areas were injected with percutaneous glue. The mean pre- and post-procedural creatinine values were 2.97 +/- 1.78 mg/dL and 1.75 +/- 1.18 respectively (p=0.002), indicating a significant difference. Nephrostomy catheters were placed for patients with elevated creatinine levels and non-dilated collecting system. The mean pre- and post- nephrostomy creatinine levels were 3.55 +/- 2.36 mg/dL and 2.57 +/- 1.82 mg/dL respectively (p>0.05), indicating no statistically significant difference. CONCLUSION: The results of our study suggest that percutaneous treatment is an effective method for the treatment of non-vascular complications following renal transplantation, and, therefore, should be the first option for the preservation of graft functions.Öğe Management of non-vascular complications following renal transplantation using percutaneousapproach(Edızıonı luıgı pozzı, vıa panama 68, 00198 rome, ıtaly, 2018) Yildirim, Ismail Okan; Berktas, Bayram; Saglik, Semih; Piskin, Turgut; Dogan, Murat; Sahin, Idris; Taskapan, Hulya; Sarac, KayaOBJECTIVE: Non-vascular complications following renal transplantation can cause graft failure. In this study, we present our two-year experience with percutaneous treatment for non-vascular complications following renal transplantation. PATIENTS AND METHODS: A total of 30 patients who underwent percutaneous radiological treatment between March 2014 and July 2016 were included in the study. RESULTS: Following renal transplantation, a total of 36 percutaneous radiological procedures which includes hydronephrosis secondary to ureteral stricture (n. 15), clinical symptom producing lymphocele due to pressure (14) and creatinine elevated nondilated grafts (n. 7) after excluding other reasons of creatinine elevation, were performed. Six patients received percutaneous treatment for both ureteral stricture and lymphocele. The patients underwent balloon dilatation and double-J ureteral stent due to ureteral stricture. The mean pre- and post-procedural creatinine levels were 4.36 +/- 2.84mg/dL and 2.17 +/- 1.24 mg/dL respectively (p=0.004), indicating a significant difference. For lymphocele treatment, sclerosing agents were injected and lymphatic leakage areas were injected with percutaneous glue. The mean pre- and post-procedural creatinine values were 2.97 +/- 1.78 mg/dL and 1.75 +/- 1.18 respectively (p=0.002), indicating a significant difference. Nephrostomy catheters were placed for patients with elevated creatinine levels and non-dilated collecting system. The mean pre- and post- nephrostomy creatinine levels were 3.55 +/- 2.36 mg/dL and 2.57 +/- 1.82 mg/dL respectively (p>0.05), indicating no statistically significant difference. CONCLUSION: The results of our study suggest that percutaneous treatment is an effective method for the treatment of non-vascular complications following renal transplantation, and, therefore, should be the first option for the preservation of graft functions.Öğe Mortality after kidney transplantation: 10-year outcomes(Mexican Acad Surgery, 2022) Piskin, Turgut; Simsek, Arife; Murat-Dogan, Sait; Demirbas, Baha T.; Unal, Bulent; Yildirim, Ismail O.; Toplu, Sibel A.Objectives: In the past decade, advances in immunological therapy have increased the survival of kidney recipients and their grafts. However, it has not achieved the desired level of improvement. This study aims to reveal the mortality among kidney recipients. Methods: Medical data of the patients, who had undergone kidney transplantation (KT) between November 2010 and December 2020, were retrospectively reviewed. Inclusion criteria were adult kidney recipients, who had died. Exclusion criteria were pediatric recipients, recipients of en bloc and dual KT, recipients with missing data, and recipients with a primary non-functioning graft. The recipients were grouped according to their donor type; Group 1 (from a living donor) and Group 2 (from a deceased donor). Subgroup analyses were done for mortality by time-period post-transplant and for infectious causes of mortality. Results: Of 314 recipients, 35 (11.14%) died. Twenty-nine recipients were included in the study (Group 1: 17 and Group 2: 12). The most common cause of mortality was infection (58.6%), and the second was cardiovascular disease (CVD) (24.1%). Sepsis developed in 29.4% of infection-related deaths, while COVID-19 constituted 23.5% of infection-related deaths. Conclusion: Early diagnosis and treatment of infectious and CVD are important to improve survival in kidney recipients.Öğe A Novel Technique in the Treatment of Lymphoceles After Renal Transplantation: C-Arm Cone Beam CT-Guided Percutaneous Embolization of Lymphatic Leakage After Lymphangiography(Lippincott Williams & Wilkins, 2018) Yildirim, Ismail Okan; Piskin, Turgut; Duman, Enes; Firat, Ali; Dogan, Murat; Taskapan, Huelya; Sahin, IdrisBackground We aimed to evaluate the efficacy of percutaneous embolization after lymphangiography using C-arm cone-beam computed tomography (CBCT) performed at the site of lymphatic leakage in patients with postrenal transplant lymphocele. Methods Between July 2014 and August 2017, 13 patients not responding to percutaneous ethanol sclerotherapy and conservative treatment for recurrent lymphocele after renal transplant were included. The mean age of the patients was 56.38 9.91 (range, 36-70) years, and it comprised 9 men and 4 women. All patients underwent intranodal lymphangiography. C-arm CBCT-guided percutaneous embolization was performed in patients with confirmed lymphatic leakage. Patients who had no lymphatic leakage underwent drainage with fibrin glue injection. Results Lymphatic leakage was observed in 9 patients after lymphangiography, and they underwent CBCT-guided percutaneous N-butyl-2-cyanoacrylate embolization. The volume of lymphatic drainage reduced to less than 10 mL in 8 patients. One patient who was not responding to embolization was treated surgically, after percutaneous drainage and fibrin glue injection. Lymphatic leakage was not observed in 4 patients after lymphangiography. Of these, 3 patients showed a reduction in the amount of lymphatic drainage after lymphangiography. All 4 patients underwent percutaneous drainage and fibrin glue injection. One patient did not respond to the treatment and was treated surgically. Prelymphangiography and postlymphangiography and embolization, the volume of lymphatic drainage was 113.07 +/- 21.75 mL, and 53.84 +/- 30.96 mL, respectively, and statistically significant decrease was detected (P < 0.005). Conclusions Lymphangiography and CBCT-guided percutaneous embolization procedures might be an effective treatment method for patients with lymphocele refractory to treatment.Öğe A novel technique in the treatment of lymphoceles after renal transplantation: c-arm cone beamct-guided percutaneous embolization of lymphatic leakage after lymphangiography(Lıppıncott wıllıams & wılkıns, two commerce sq, 2001 market st, phıladelphıa, pa 19103 usa, 2018) Yildirim, Ismail Okan; Piskin, Turgut; Duman, Enes; Firat, Ali; Dogan, Murat; Taskapan, Huelya; Sahin, Idris; Sarac, KayaBackground We aimed to evaluate the efficacy of percutaneous embolization after lymphangiography using C-arm cone-beam computed tomography (CBCT) performed at the site of lymphatic leakage in patients with postrenal transplant lymphocele. Methods Between July 2014 and August 2017, 13 patients not responding to percutaneous ethanol sclerotherapy and conservative treatment for recurrent lymphocele after renal transplant were included. The mean age of the patients was 56.38 9.91 (range, 36-70) years, and it comprised 9 men and 4 women. All patients underwent intranodal lymphangiography. C-arm CBCT-guided percutaneous embolization was performed in patients with confirmed lymphatic leakage. Patients who had no lymphatic leakage underwent drainage with fibrin glue injection. Results Lymphatic leakage was observed in 9 patients after lymphangiography, and they underwent CBCT-guided percutaneous N-butyl-2-cyanoacrylate embolization. The volume of lymphatic drainage reduced to less than 10 mL in 8 patients. One patient who was not responding to embolization was treated surgically, after percutaneous drainage and fibrin glue injection. Lymphatic leakage was not observed in 4 patients after lymphangiography. Of these, 3 patients showed a reduction in the amount of lymphatic drainage after lymphangiography. All 4 patients underwent percutaneous drainage and fibrin glue injection. One patient did not respond to the treatment and was treated surgically. Prelymphangiography and postlymphangiography and embolization, the volume of lymphatic drainage was 113.07 +/- 21.75 mL, and 53.84 +/- 30.96 mL, respectively, and statistically significant decrease was detected (P < 0.005). Conclusions Lymphangiography and CBCT-guided percutaneous embolization procedures might be an effective treatment method for patients with lymphocele refractory to treatment.Öğe Open Donor Nephrectomy is a Safe Approach for Starting Kidney Transplantation(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2013) Unal, Bulent; Piskin, Turgut; Yilmaz, SezaiAim: Living kidney donation is important due to the shortage of organ donors in Turkey. Classic retroperitoneal open donor nephrectomy is more beneficial as it can prevent intraperitoneal organ injuries and postoperative adhesion formation. Here we have presented our initial experience about donors who were undergone open donor nephrectomy. Material and Methods: We retrospectively analyzed 14 donors who were undergone open nephrectomy between November 2010 and June 2011. We reviewed demographic data, intraoperative and postoperative complications, hospital stay, and serum creatinine levels (discharge time, postoperative maximum level and currently) for these donors. Results: Fourteen donors were operated during this period. The male to female ratio was 8:6 among donors. Mean age was 43.57 (range; 27-68) years. Mean body mass index was 27.71 (range; 21.3-36.1). Five right and nine left kidneys were harvested. There was no intraperitoneal organ injury. All kidney grafts started to function immediately. There was no vascular thrombosis in the transplanted kidneys. There was one major hemorrhagic complication requiring reoperation (7.1%). There were three minor wounds complications (21.4%). None of the donors had incisional hernia. Mean postoperative hospitalization time was 5.85 (range; 4-18) days. Mean flow up period was 125 days (range; 18-210 days). Mean serum creatinine level of discharge time, postoperative maximum level, and currently were; 1.04 mg/dL (range; 0.6-1.7); 1.26 mg/dL (range; 0.8-1.9); 1.08 mg/dL (range; 0.78-1.41) respectively. Conclusions; We did not have any major complication in our initial series for open donor nephrectomy. For those who are starting kidney transplantation, open donor nephrectomy is a safe method.Öğe Orifice Location Guided Excision and Flap Procedures for Treatment of Sacrococcygeal Pilonidal Disease(Wroclaw Medical Univ, 2011) Piskin, Turgut; Olmez, Aydemir; Mecit, Eren A.; Unal, Bulent; Aydin, Cemalettin; Kayaalp, CuneytBackground. Although various surgical techniques have been described, there is no consensus on the optimal treatment for sacrococcygeal pilonidal disease (SPD). Objectives. The aim of this study is to report the medium-term results of three different surgical methods used to treat SPD that were chosen according to the localization of the sinus orifices. Material and Methods. Between November 2005 and April 2007, 43 patients with symptomatic SPD were treated by three different surgical methods. A classic approach, a modified flap technique and a new excision and flap technique were evaluated for treating SPD cases with different localizations of the sinus orifices. The study was carried out on the basis of retrospective reviews of patient charts and telephone interviews for prospective evaluation. Outcome measures included wound complications, time off work, complete healing time, paresthesia, recurrence rates and satisfaction with the procedures and outcomes. Results. There were no early postoperative complication among the 43 patients. The median hospitalization time was 6.76 days (2-12 days). The authors reached 31 patients (72.09%) by phone for the interview; the median follow-up time was 48.41 months (range 42-59 months). No recurrences were reported. The median time off work and complete healing time were 20.54 and 18.61 days, respectively. All but three of the patients reported satisfaction with the esthetic outcome. All the patients reported satisfaction with the effectiveness of the surgical approaches used. One patient reported dissatisfaction with the anesthesia technique. There were complaints of paresthesia from eight patients (one severe, seven moderate). All the patients said that they would recommend these operations and anesthesia techniques to relatives or other patients with sacrococcygeal pilonidal disease. Conclusions. Different excision and flap methods should be used to treat cases of sacrococcygeal pilonidal disease with different localizations of the sinus orifices (Adv Clin Exp Med 2011, 2011, 4, 481-488).Öğe Percutaneous Drainage of a Splenic Abscess via Laparoscopic Trocar in a Kidney Transplant Patient(Baskent Univ, 2022) Aktas, Aydin; Kayaalp, Cuneyt; Gundogan, Ersin; Gunes, Orgun; Piskin, TurgutSpleen abscess is a life-threatening disease. Treatment can be done by medical, radiological, or surgical methods. Here, we offer an innovative method of laparoscopic trocar-assisted percutaneous abscess drainage in the treatment of splenic abscess. Our patient, a 48-year-old male who had a kidney transplant 3 years previously, was admitted due to abdominal pain and fever. A-25-cm splenic abscess was detected, and ultrasonography-guided percu - taneous catheter 10F drainage was attempted. However, this attempt was not successful due to the high viscosity of the abscess content. Under general anesthesia, we then attempted abscess drainage percutaneously via a 12-mm laparoscopic trocar, and a large-bore drain of 28F was inserted into the abscess cavity. The drainage was successful (5300 mL high viscosity content) without any complications. The patient was discharged on day 8 and remained well at 9-month follow-up. Percutaneous drainage instead of splenectomy is preferred in the treatment of spleen abscess by preserving the immunologic functions of the spleen, particularly in immunocompromised patients. When percutaneous catheter drainage therapy fails, percutaneous treatment with a laparoscopic trocar is an innovative and reliable alternative.Öğe Preoperative progressive pneumoperitoneum for giant inguinal hernias(K Faisal Spec Hosp Res Centre, 2010) Piskin, Turgut; Aydin, Cemalettin; Barut, Bora; Dirican, Abuzer; Kayaalp, CuneytReduction of giant hernia contents into the abdominal cavity may cause intraoperative and postoperative problems such as abdominal compartment syndrome. Preoperative progressive pneumoperitoneum expands the abdominal cavity, increases the patient's tolerability to operation, and can diminish intraoperative and postoperative complications. Preoperative progressive pneumoperitoneum is recommended for giant ventral hernias, but rarely for giant inguinal hernias. We present two giant inguinal hernia patients who were prepared for hernia repair with preoperative progressive pneumoperitoneum and then treated successfully by graft hernioplasty. We observed that abdominal expansion correlated with the inflated volume and pressure during the first four clays of pneumperitoneum. Although insufflated gas volume can be different among patients, we observed that the duration of insufflation may be the same for similar patients.
